The ratio of nurses to patients essay paper

The ratio of nurses to patients essay paper.

The ratio of nurses to patients essay paper




For a vast period, the debate regarding the ratio of nurses to patients has been in the limelight. While many hospitals try to cut on cost by limiting the number of health care workers, that is, nurses in the facilities, the number of inpatient and outpatient demands have been on the rise thereby creating a disconnect in the patient-to-nurse ratio. While too many nurses can be costly for hospitals, too few can put patients’ health in danger. As such, the proper number of hours nurses work otherwise known as the “target level” should be adjusted each shift, depending on the ebb and flow of patients and their need for care. 

In this regard, a team of researchers from the UCLA School of Public Health, Mayo Clinic, and Vanderbilt University researched to establish the correlation between target level and mortality rate, that is, the rate at which patients die when the number of nurses is varied. In the process, Needleman et al (2011) established that patients’ mortality risk rises as the number of below-target nursing shifts they are exposed to increases. The study also found that when nurses’ workloads increase during shifts because of high patient turnover, mortality risk also increases. The study design chosen for this research was the randomized controlled trial. According to the study, the researchers analyzed the records of nearly 198,000 admitted patients and 177,000 eight-hour nursing shifts across 43 patient-care units at a large tertiary academic medical center in the United States. The researchers also calculated the difference between the target nurse-staffing level and the actual nurse-staffing level for each shift they examined as part of their comprehensive analysis. The researchers collected the data regarding the number of nurses assigned to each of the patients in all the healthcare units used for the study. These data were effective in comparing the different shifts vis-à-vis the number of patients admitted in each shift in a bid to establish the shift in which mortality rate was significantly higher. 

The only bias to which the study was subjected was the analogy that mortality rates are higher in shifts with fewer nurses when compared to shifts with an adequate number of nurses. However, this bias was confirmed by the findings below: each shift patients were exposed to that was substantially understaffed, falling eight or more hours below the target level, patients’ overall mortality risk increased by 2 percent. This was because the average patient in the study was exposed to three nursing shifts that fell below target levels; the mortality risk for these patients was about 6 percent higher than for patients on units that were always fully staffed. The study also established that when nurses’ workloads increase because of high patient turnover in individual units, mortality risk also increases; this establishment upheld the bias even further. The conclusions made during the research were that mortality rates are higher when the patient-nurse ratio is disproportionate in the sense that when fewer nurses care for a greater number of patients, mortality rates are higher when compared to the otherwise scenario. Notably, this study can be beneficial to a health care manager, especially on staffing because it provides valuable insights into the effectiveness of adjusting the number of nurses depending on the number of patients admitted at a particular time.


Needleman et al. (2011). Nurse staffing and inpatient hospital mortality. New England Journal of Medicine364(11), 1037-1045.

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